Analysis of clinical outcomes with respect to spermatozoan origin after artificial oocyte activation with a calcium ionophore

Abstract

Purpose Fertilization failures have occurred repeatedly in reproductive centers after intracytoplasmic sperm injection (ICSI) and artificial oocyte activation (AOA) has been used to prevent it. This study was performed to investigate whether spermatozoan origin influences clinical outcomes of AOAwith a calcium ionophore. Methods A total of 185 ICSI cycles with a history of no or low fertilization was included in this retrospective study. The outcomes of AOA after ICSI were compared with ejaculatednormal, ejaculated-oligo-astheno-terato or extracted-testicular spermatozoa. Results There were significant differences between the previous standard ICSI cycles and AOA cycles in the rate of fertilization and clinical outcomes among cases with different sperm origins. Thirty-eight healthy babies (20 singles and 18 twins, 29 cycles) were successfully delivered, and no congenital birth defects were observed. Conclusions Most patients with a no or low fertilization history obtained an increased fertilization rate and a positive clinical outcome with AOA regardless of the origin of spermatozoa.

Oocyte activation by calcium ionophore and congenital birth defects: a retrospective cohort study

“…These findings indicate that neonatal outcomes in the ICSI-Ca versus ICSI protocol did not have obvious differences, regardless of normality or adverse consequences. A previous study demonstrated similar results regarding birth weight and gestational age (11). These findings might suggest that although the ICSI-Ca procedure involves additional manipulation on the oocyte, it does not have an effect on pregnancy outcome.…”

“…One study included a cohort of 38 babies (20 singles and 18 twins in 29 cycles). All neonates were delivered after ICSI-Ca procedure, and no congenital birth defects were observed in this group (11). Vanden Meerschaut et al also evaluated 21 children ages 3-10 years who were born after AOA and found that they all lay within expected ranges regarding neurodevelopmental, intelligence, language, and communication skills (13).…”

“…There is a paucity of data regarding the possible adverse effects of calcium ionophore on postimplantation embryo and neonatal outcomes. One retrospective study found no congenital defects in 38 children conceived after ICSI and AOA procedures (11). Takisawa et al also found no difference regarding growth and health parameters of 10 babies at birth between both AOA protocols compared with ICSI (12).…”

An effective method for improving outcomes in patients with a fertilization defect

“…The calcium ionophore A23187 (Sigma Chemical, Sigma, St Louis, MO, USA) was used for AOA, as previously described [ 5 ]. The final solution (10 µmol/L) was prepared prior to ICSI or IMSI.…”

“…In a preliminary study, increased fertilization rates and significantly higher clinical pregnancy and implantation rates were achieved using AOA following ICSI compared with the previous treatment with standard ICSI in a group of patients who had experienced total fertilization failure or low fertilization rates (<50%) in their previous ICSI cycles. Furthermore, 38 healthy babies were delivered from 185 ICSI cycles by using AOA with a calcium ion [ 5 ]. These results support the safety of AOA with a calcium ionophore and suggest the effectiveness of AOA for ICSI cycles in patients with previous experiences of zero or low fertilization rates.…”